Abstract: | Infants who are prenatally exposed to cocaine have an increased risk of suffering neonatal medical complications. We hypothesized that this effect is mediated by the relation between cocaine use and prenatal medical risk of the mother, birth weight, and intrapartum risk, that would lead to increased neonatal complications. This study used structural equation modeling to assess the direct and indirect effects of prenatal cocaine exposure on neonatal medical risk in a sample of 337 neonates. Prenatal cocaine exposure had a significant indirect, but not direct effect on neonatal medical risk. Several paths contributed to this indirect effect. The strongest was via cocaine's impact on birth weight, and birth weight's effect on neonatal medical risk. The paths through prenatal risk and intrapartum risk also contributed to the total indirect effect. These results suggest that the observed relation between prenatal cocaine exposure and neonatal medical complications is mediated by prenatal and intrapartum risk factors. |